Vasodilation and Reduction of Systolic Blood Pressure after One Session of High-Intensity Interval Training in Patients With Heart Failure with Preserved Ejection Fraction

Abstract

BackgroundHeart failure with preserved ejection fraction (HFpEF) is a multifactorial syndrome characterized by a limited exercising capacity. High-intensity interval training (HIIT) is an emerging strategy for exercise rehabilitation in different settings. In patients with HFpEF, HIIT subacute effects on endothelial function and blood pressure are still unknown.ObjectiveTo evaluate the subacute effect of one HIIT session on endothelial function and blood pressure in patients with HFpEF.MethodsSixteen patients with HFpEF underwent a 36-minute session of HIIT on a treadmill, alternating four minutes of high-intensity intervals with three minutes of active recovery. Brachial artery diameter, flow-mediated dilation, and blood pressure were assessed immediately before and 30 minutes after the HIIT session. In all analyses, p <0.05 was considered statistically significant.ResultsThere was an increase in brachial artery diameter (pre-exercise: 3.96 ± 0.57 mm; post-exercise: 4.33 ± 0.69 mm; p < 0.01) and a decrease in systolic blood pressure (pre-exercise: 138 ± 21 mmHg; post-exercise: 125 ± 20 mmHg; p < 0.01). Flow-mediated dilation (pre-exercise: 5.91 ± 5.20%; post-exercise: 3.55 ± 6.59%; p = 0.162) and diastolic blood pressure (pre-exercise: 81 ± 11 mmHg; post-exercise: 77 ± 8 mmHg; p = 1.000) did not change significantly. There were no adverse events throughout the experiment.ConclusionsOne single HIIT session promoted an increase in brachial artery diameter and reduction in systolic blood pressure, but it did not change flow-mediated dilation and diastolic blood pressure.

Effects of different exercise modalities on cardiac dysfunction in heart failure with preserved ejection fraction

“…30 HIIT was associated with improved clinical outcome in human HFpEF, 31 however potentially related to non-cardiac training effects. 32 In the present study, MICT and HIIT significantly reduced resting SR Ca 2+ leak in LV cardiomyocytes. As we and others have shown earlier in other types of HF, a reduction in SR Ca 2+ leak may attenuate cardiac remodelling and deterioration of contractile function in vivo.…”

“…Moderate‐intensity continuous training and HIIT have both been proven to be effective interventions to reduce endothelial dysfunction in the ZSF‐1 metabolic HFpEF model 30 . HIIT was associated with improved clinical outcome in human HFpEF, 31 however potentially related to non‐cardiac training effects 32 . In the present study, MICT and HIIT significantly reduced resting SR Ca 2+ leak in LV cardiomyocytes.…”

“…cytosolic Ca 2+ removal). Indeed, in previous studies, positive effects of HIIT on diastolic function were attributed to decreased stiffness or improved cardiac vagal tone 32,35 …”

“…Indeed, in previous studies, positive effects of HIIT on diastolic function were attributed to decreased stiffness or improved cardiac vagal tone. 32,35 In MICT, additional parameters of in vivo function were improved as both SV and EDV increased upon training. Interestingly, CaT amplitudes were smaller in LV cardiomyocytes from MICT.…”

High Intensity Exercises in Heart Failure with Preserved Ejection Fraction

“…In this interesting study, designed for the assessment of the acute effects of a single session of high-intensity interval training, Lima et al 12 studied post-training changes in blood pressure (BP) and endothelial function in 16 patients with HFpEF. As main results, it was possible to demonstrate a significant increase in the brachial artery diameter with a corresponding reduction in systolic BP.…”